Sixty-eight bipolar patients in remission on lithium prophylaxis with adequate serum lithium levels were cross-sectionally studied to assess the relation of certain psychosocial variables (life events, social support and daily hassles) with psychopathology and psychosocial functioning. The daily hassles and number of life events were found to have significant positive correlation with Hamilton Depression Rating Scale (HDRS) scores while perceived social support score had significant negative correlation with general psychopathology score. In stepwise multiple regression analyses, psychosocial variables taken together explained 7% - 23% of variance in psychopathology and global functioning of these patients. We conclude that psychosocial variables may have a modest but significant relation with the clinical and psychosocial functioning of bipolar patients stabilized on lithium prophylaxis.

Impulse control disoders have long been recognized. Although included in nosological systems since two decades, their diagnostic validity individually, as well as a category remains in question. Conceptually, these have been linked to variety of other psychiatric or medical disorder viz. OCD, affective disorders, addictive disorders, organic mental conditions etc, but systematic studies have not been done. The present review focuses on the nosological and conceptual evolution of these disorders and highlights the overlap and boundaries with other psychiatric disorders.

The role of stressful life events in the etiology of various disorders has been of interest to investigators attempting to establish a link between stressful life events and disorders. None of the available scales are relevant to service personnel. In the present study an attempt was made to construct a scale to measure stressful life events in service personnel. In the first stage of study open-ended questions along with items generated by the expert group by consensus method were administered to 50 soldiers. During the second stage the scale comprising of 59 items was administered in group setting to 165 service personnel. Weightage was assigned on 0-100 range Frequency of occurrence of life events within past one year and lifetime was also noted. Findings revealed that service personnel experience more number of life events within a year as well as in lifetime. Some general items, which are common to civilians are having consistency of weightage being assigned. There is a pattern of uniformity with the civilian counterparts along with differences in the items specific to service personnel.

This study examines the relationship between social support, coping resources and codependence in the wives of individuals with drug and alcohol dependence. Thirty male individuals each with drug and alcohol dependence were assessed for severity of addiction by Addiction Severity Index (ASI). Their wives were administered Social Support Scale (SSS). Coping Resources Inventory (CRI) and Codependence Assessment Questionnaire (CAQ). Of the sixty patients, forty nine were found to be codependent. On ASI, the codependent group had more impairment in the financial and the legal domains of the husbands whereas non codependent group had more impairment in the psychological domain. Codependent wives had lower coping resources and social support. On multivariate analysis, three variables were found to be significant predictors of the development of codependence in the wives. These were (i) husbands'duration of drug or alcohol abuse, (ii) total CRI score and (Hi) husbands' ASI employment score.

In a naturalistic longitudinal design 133 consecutive inpatients with alcohol dependence syndrome were followed up for one year following discharge from the hospital. 59 patients (group 1) paid follow up visit at regular intervals whereas 28 subjects (group 2)never returned despite three consecutive postal intimations. Rest of the patient were irregular in follow up. The individuals in group 1 were compared with those in group 2 on various sociodemographic and clinical variables with the aim of delineating the characteristics that could define the alcoholics who dropped out following discharge. It was found that such patient were relatively younger with lower level of education, less frequently married, had earlier onset of problem drinking with poor social support and higher rates of mental problems. It was concluded that post discharge attrition of alcoholics could be a social as well as a clinical problem in any setting rendering long treatment for alcoholism.

One hundred and fifty seven suicide attempters who were the wives of substance abusers were interviewed with the help of a self innovated proforma that was designed to explore the causative factors for their suicidal behaviour. These subjects were selected from the Intensive Medical Care Unit of Government Stanley Hospital, Chennai. Some of the family and personal problems encountered by them that were attributable to their husbands' behaviour, such as disturbed relationship with the relatives (84.7%), being manhandled by their husbands (79.5%)', financial problems (76.4%) and deprivation of emotional support and love (51%), were scarecely different from those noted in other reports on attempted suicide. Nonetheless, besides the fighting behaviour of their spouses with others (58.6%), the influence of the symptoms of delusional jealousy (24.8%) and suicidal ideas (14,0%) manifested by their husbands as driving forces for their suicidal behaviour might be of specific relevance to this group of suicide attempters. The cultural influence on the behaviour of our women in response to these psychiatric symptoms of their husbands has been highlighted.

Mania has been known to result in undesirable consequences like illegitimate pregnancies, financial losses and ruined carriers. An early identification of the syndrome should result in early diagnosis and treatment and limit these undesirable consequences. This study was thus carried out to study the evolution of the manic episode and the factors influencing it. The guardians of 98 consecutive drug free manic patients were given a symptom check list and asked to rate the symptoms in the order of appearance and the duration of each symptom. It was found that there were no consistent patterns of evolution. The median duration of evolution was 45 days. Females and patients with life events had a shorter evolution period.

Mania in HIV infected individuals is an uncommon clinical presentation. It can, however, complicate any stage of the HIV infection. We herewith report a set of three case reports of patients with HIV infection who developed manic episodes. The cases highlight some aspects of the plausible relationship between HIV infection and mania. HIV infection could be revealed by manic episode, it could itself also be associated with increased cycling in bipolar patients. Mania could be secondary to HIV or zidovudine therapy (though the etiological role of the latter is as yet unclear). Mania could also occur as a reaction to awareness to having HIV infection. These relationships are important for both the physician and the psychiatrist as they have important therapeutic and prognostic implications.

We had reported earlier (1998) a high percentage of moderate to severe EEG abnormalities (43.75% of cases) amongst adolescent manic population. Sixteen adolescent manics, with a mean age of 14 9 years, diagnosed according to ICD-10 were taken up for the initial study. Present study is the three-year follow-up report of 67.75% (11 out of 16) of the original patient population. All these patients were subjected fc 21-channel EEG and anticonvulsant drugs were started to all. Follow-up data showed that 3 out of 6 patients, who discontinued medications, were relapsed during this 3 years period. But none of the 5 patients, who regularly took prescribed medicines, relapsed during the same period. Significance of these findings in relapse prevention and the role of anticonvulsants, particularly in relation to adolescent mania, have been emphasized.

Several passages are available to test verbal (logical) memory. Those standardized for use in India are, however, short and simple. As a result, limited dispersion of scores, or ceiling effects, are observed when these tests are administered to young and highly educated populations. This study presents an exercise in the development and standardization of a longer and more complex passage. The passage was administered to 121 residents of Bangalore and 92 residents of Cochin. Significant effects of age decade, gender, and city were observed on memory performances. Group data are presented for each decade of life; these have potential normative value. It is suggested that this test will be useful when assessing populations in whom the conventional passages fail to provide adequate dispersion, or result in ceilling effects.

The aim of the present study was to assess the efficacy and safety of olanzapine in the treatment of schizophrenic patients. 27 patients were randomly assigned to treatment with olanzapine or haloperidol over 12 weeks. The primary efficacy measure was the mean change from baseline to endpoint in total scores on the Brief Psychiatric Rating Scale (BPRS) and assessing treatment emergent adverse events. Secondary measures were positive symptoms, negative symptoms, general psychopathology depression, anxiety and quality of life. Compared to haloperidol, olanzapine had equal effect in improving overall psychopathology, positive symptoms, and severity of schizophrenic illness. Olanzapine showed supehor improvement on negative symptoms and secondary depressive features. Commonest side effects were weight gain, sleepiness and increased duration of sleep. Olanzapine is effective in improving overall psychopathology including positive symptoms, negative and secondary depressive features in Indian patients with schizophrenia and it is safe and well tolerated at dosage between 5 to 20 mg/day

A girl of 19 years who presented with the typical features of Anorexia Nervosa is reported and the condition is briefly discussed.

Asperger's syndrome is an autistic spectrum disorder, which has engendered lesser attention in comparison to autism. Recent literature has focused on the involvement of cortical areas of the brain in this syndrome. We report a case of Asperger's syndrome in which an extensive work-up, including neuropsychological, neurophysiological and neuroimaging procedures, were undertaken. The findings of the various investigative procedures are discussed and literature supporting the neurobiological basis of Asperger's syndrome is highlighted. Finally, we briefly touch upon the 'Theory of Mind' construct in autistic spectrum disorders.

Ganser's syndrome is a rare and controversial entity in psychiatric nosology. We report two cases ofGS, one developing in a 12-year-old boy, which had their onset during an episode of mania. After recovery from Ganser's syndrome, these cases were followed-up for two and five years, respectively. Interestingly both these patients evolved into bipolar disorder with one patient showing recurrence of Ganser symptoms with each subsequent episode. The importance of following-up and relevance of affective symptoms in GS is discussed.

Two cases of Kleine-Levin Syndrome with illness duration of three and four months respectively are presented. Both cases in their adolescence presented with typical features of the syndrome-onset after high grade fever episodic course and spontaneous remission of each episode and normalcy in between the episodes Characteristic features of each episode in both cases were hypersomnia, eating excessively, disinhibited behaviour, affective features like irritability social withdrawal and lack of personal care and cognitive disturbance. The second case had sexual disinhibition which is another important feature seen in Kleine-Levin Syndrome. Both patients responded well to lithium therapy.

Rabbit syndrome is described as a late onset extrapyramidal side effect of antipsychotic therapy. In the present case rabbit syndrome is described in a young adult as an acute complication of treatment with haloperidol which showed a favourable response to the anticholinergic treatment. Key Words: Rabit Syndrome, antipsychotics,anticholinergic agent.

Plica neuropathica also known as plica polonica is an uncommon condition in which the hairs of the scalp in a localised area is compacted into irregularly twisted, irreversibly entangled plaits. A review of literature shows several predisposing factors figuring in plica neuropathica like kinky hair, use of shampoos, febrile illness and psychological disturbances. The authors describe a case of plica neuropathica in a paranoid schizophrenic patient who developed irreversible tangling of scalp hair.